Heart failure(HF) is the terminal stage of various cardiovascular diseases, characterized by high morbidity and mortality, and it represents one of the major disease burdens for families and society. In recent years, as research on the molecular mechanisms of HF has deepened, a competing endogenous RNA(ceRNA) network mediated by long non-coding RNAs(lncRNAs) and circular RNAs(circRNAs) has been gradually constructed. Extensive research results have confirmed that the ceRNA network is widely involved in pathological processes such as inflammation, oxidative stress, myocardial hypertrophy, apoptosis, remodeling of extracellular matrix components and structure, and ferroptosis in HF. It reveals the complex pathological mechanisms of HF at the epigenetic level. Traditional Chinese medicine(TCM) plays a unique role in improving symptoms and prognosis of HF and intervenes in the ceRNA network in HF through multi-level and multi-target mechanisms. It improves key pathological processes such as myocardial fibrosis and inflammation, making progress in treating HF at the molecular level. This article summarized recent Chinese and international research on the regulatory mechanisms of ceRNA networks in HF, elaborated on the mechanisms of action of ceRNA networks in different pathological stages of HF, and summarized how effective components and compounds of TCM intervene in the ceRNA network to improve HF, so as to refine the molecular mechanisms of HF and provide directions for more precise molecular targeted therapeutic strategies.

Sexual difficulties are common among Australian men, affecting over half the population regardless of age or sexual identity. It can have significant impacts on physical health, mental well-being, and quality of life if left untreated. The present study aimed to examine sexual difficulty trends, sources of seeking help, and factors associated with sexual help-seeking behavior among a cohort of Australian men. Four waves of data from the Australian Longitudinal Study on Male Health (Ten to Men) were used in the analysis. We included men aged 18 years and above who had engaged in vaginal, oral, or anal sex, leading to a total sample size of 12,737 (wave 1), 8,933 (wave 2), 6,991 (wave 3), and 5,804 (wave 4) men. Logistic regression was undertaken to identify factors associated with sexual help-seeking behavior. Across the four waves, there was a significant rise in the prevalence of men experiencing at least one form of sexual difficulty, increasing from 54.1% (95% CI 52.7, 62.5) in 2013/14 to 64.7% (95% CI 62.8, 66.7) in 2022. The increase in prevalence of sexual difficulties was more pronounced among men from culturally and linguistically diverse backgrounds which increased from 42.8% (95% CI 38.1, 47.5) in 2013/14 to 61.5% (95% CI 55.6, 67.1) in 2022. Around 17.6% of men sought assistance for their sexual health concerns in 2022, with no significant change over the study period. Number of sexual difficulties, age, sexual identity, relationship status, conformity to masculine norms, depression, and number of financial hardships were factors significantly associated with sexual health-seeking behavior. Despite the burden of sexual difficulties increasing among Australian men, few have sought assistance, suggesting a significant level of unmet sexual health need. This underscores the necessity of evaluating current services and considering co-designed sexual health initiatives, informed by an intersectional approach, to enhance accessibility, engagement, and responsiveness to the distinct sexual health needs and preferences of men from a range of communities.

To observe the clinical efficacy of acupotomy at trigger points combined with meridian sinew manipulation in treatment of early and mid-term knee osteoarthritis (KOA), and investigate whether its therapeutic mechanism is related to the regulation of inflammatory response.

Seventy-four patients with early and mid-term KOA were randomly divided into the control group (37 cases, with 2 cases dropouts) and the observation group (37 cases, with 1 case dropout). The control group was treated with meridian sinew manipulation for 30 min each time, 5 times a week, for 4 consecutive weeks. The observation group was given acupotomy at trigger points on the basis of the treatment of control group, once a week, for 4 consecutive weeks. Western Ontario and McMaster University osteoarthritis index (WOMAC) scores, short-form McGill pain questionnaire (SF-MPQ) scores, the medical outcome 36-item short form health survey (SF-36) scores, serum inflammatory factors content before and after treatment were compared between the two groups. The clinical efficacy were assessed after the treatment.

Compared with those before treatment, the total scores and the scores of pain, stiffness and activity impairment of WOMAC, the pain rating index (PRI), visual analog scale (VAS) and present pain intensity (PPI) scores of SF-MPQ, and the contents of serum tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 in both groups were significantly decreased after treatment (P<0.05), while the scores of the physical component summary (PCS) and the mental component summary (MCS) of SF-36 were significantly increased (P<0.05). Compared with the control group, the total scores, scores of pain, stiffness and activity impairment of WOMAC, the PRI, VAS and PPI scores of SF-MPQ, and the contents of serum TNF-α, IL-6 and IL-10 in the observation group were significantly decreased after treatment (P<0.05), while the scores of PCS and MCS of SF-36 were significantly increased (P<0.05). The total effective rate of the observation group was 94.4% (34/36) after treatment, which was significantly higher than that of the control group (74.3%, 26/35, P<0.05).

Acupotomy at trigger points combined with meridian sinew manipulation can significantly improve the clinical symptoms such as joint pain, stiffness and limited activity in patients with KOA, improve the quality of life, and its mechanism may be related to reducing the inflammatory response.

Mental health literacy (MHL) plays a crucial role in promoting mental health and early identification of psychological issues among students. Identifying the determinants of MHL can contribute to the development of effective educational interventions and policies. This study aimed to investigate the factors influencing MHL among high school students in Khoy, Iran.

This cross-sectional study was conducted on 564 high school students selected through a two-stage cluster sampling method from six health-promoting schools in Khoy. Data collection tools included a demographic questionnaire and a standardized mental health literacy questionnaire. Data were analyzed using MANOVA, Pearson correlation, and multiple linear regression tests. This project has an ethics approval code.

The results indicated that male students had significantly lower mental health literacy (MHL) scores compared to female students (β=-3.51, p<0.001). Maternal education and occupation were identified as significant predictors, with students whose mothers had university education (β=-5.64, p=0.03) or were employed (β=-2.33, p=0.02) achieving higher MHL scores. Similarly, students with employed fathers also scored higher (β=-1.92, p=0.03). No significant associations were found between MHL and economic status, living situation, or parental age.

Based on the findings of the study, gender, maternal education, and parental occupation significantly influence students' mental health literacy (MHL). Therefore, it is recommended that educational interventions and targeted strategies be implemented to enhance MHL, with a particular focus on male students and those from families with lower educational and occupational status. Such efforts should aim to address existing disparities and promote equitable access to mental health resources and knowledge.

Research indicates that women and girls face gender-specific stressors related to sanitation that affect their mental health, and women's decision-making agency may play a role in this relationship. This study aimed to quantitatively assess the association between women's sanitation-related decision-making - overall, within the household, and within the community - and well-being in two urban municipalities in Bangladesh. This paper is a secondary analysis of cross-sectional survey data collected from 1449 women in Meherpur and Saidpur, Bangladesh from March-April 2022. We measured well-being using the World Health Organization Well-being Index [WHO-5] and primary exposures included women's sanitation-related decision-making and access to an unshared latrine. Decision-making was measured using the Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) scale; the full-scale score was utilized in the first analysis and the five individual factor scores were used in the second. Linear regression models were employed to assess the associations between decision-making and well-being scores, controlling for life stage, socioeconomic level, perceived social support and self-reported physical health. Analyses were conducted with city as a fixed effect and also stratified by city. Mean well-being scores were moderate in both cities, with approximately 20 % of respondents reporting poor well-being. On average, women generally agreed that they had a role in sanitation-related decision making (mean score = 2.66 on a 1-4 scale, with higher scores indicating stronger agreement that they had the ability to make sanitation-related decisions). In the full models using the full decision-making scale score, results indicated a positive association between the overall decision-making scale score and well-being (β = 0.73, p = 0.02). In full models using decision-making factor scores, we observed a positive association between well-being and individual decision-making factor scores for the ability to influence community-level sanitation decisions (β = 1.10, p = 0.0002) and to make small household sanitation decisions (β = 1.07, p = 0.006). Conversely, the ability to participate in community-level sanitation decisions was negatively associated with well-being (β = -0.68, p = 0.02). The ability to participate in household sanitation decisions and make large household sanitation decisions were not associated with well-being. Access to an unshared latrine was not associated with well-being in fully adjusted models. The relationships between decision-making factors and well-being varied in analyses stratified by city. Women's involvement in sanitation-related decision-making likely varies based on the extent of their participation, the nature of the decisions, and a range of contextual and household- or individual-level factors (e.g., socioeconomic level, age, education). To effectively improve women's well-being, sanitation programs must be informed by context-specific research exploring sanitation-related decision-making and its mediators among the populations of interest.

Electronic cigarettes (e-cigarettes) are the most common tobacco product used by adolescents, yet no evidence-based cessation treatment for adolescents exists.

Wisconsin residents aged 13 to 17 (N = 227) completed an online survey assessing e-cigarette use, knowledge, motivations around using and quitting, and recommendations for cessation intervention content.

Most of our sample never vaped (76.2%), reporting concerns with health effects and addiction as motivations preventing initiation. Among adolescents who used e-cigarettes, friend use was the main motivation for initiation, and mental health symptoms promoted ongoing use. Motivations for quitting included health harms, cost, and addiction.

This study identified various topics that motivate and demotivate e-cigarette use among adolescents. This information can be incorporated into prevention and treatment strategies tailored to adolescents.

Electronic cigarette (e-cigarette) use is prevalent among young adults, yet cessation treatment options are limited and underutilized.

Wisconsin residents aged 18 to 24 who had vaped nicotine in the past month (N = 480) completed an online survey assessing vaping initiation, past quit experiences, future quit intentions, and treatment knowledge and preferences. The survey also assessed perceived physical and mental health harms of vaping nicotine and other products (eg, cannabis, cannabidiol).

Most young adults had made a prior e-cigarette quit attempt, commonly motivated by concerns about addiction, cost, and health problems. Though 80% want support to quit, preferred methods of support were highly variable. The same methods (eg, medication, friends/family, health care provider, therapist) that were most endorsed as the form of support young adults were most likely to use were also among the most endorsed forms of support that young adults would not want to use. Nearly 40% of participants reported vaping cannabis and perceived vaping cannabis as significantly less harmful than vaping nicotine or tobacco for physical and mental health.

Vaping cessation resources that are responsive to young adults' needs and preferences are needed. The high variability in treatment preferences suggests that multiple strategies need to be offered; there is no one-size-fits-all approach. Cannabis vaping is prevalent, and an important area for future research is to examine the impact of cannabis vaping on nicotine vaping dependence, cessation, and treatment use. Strategies to reach, motivate, and engage young adults in e-cigarette cessation and cessation treatment should highlight their concerns about addiction, costs, health harms, and desired treatment options.

To help combat a shortage of child and adolescent psychiatrists and assist primary care providers in managing pediatric mental health care cases, the Medical College of Wisconsin established the Wisconsin Child Psychiatry Consultation Program. The program provides educational support to primary care providers with mild to moderate pediatric mental health concerns via phone or email consultation with board-certified child and adolescent psychiatrists, as well as offering on-demand didactic training sessions and assistance locating therapeutic resources.

We sought to assess participating primary care clinicians' satisfaction with consultations and their perceptions of program services, specifically its impact on self-reported diagnostic decision-making and patient outcomes.

Primary care providers' responses to both post-consultation and annual surveys were analyzed to determine the program's impact. Five survey questions used a 5-point Likert scale, and 1 "select-all-that-apply" question was included on the post-consultation survey.

Overall, 99.2% of respondents were satisfied with their most recent consultation. Additionally, mean Likert scale scores assessing provider confidence after program enrollment in the areas of diagnosing (mean 3.7, SD 0.8), prescribing medications (mean 3.6, SD 0.9), and managing child mental health problems (mean 3.5, SD 0.9) were all significantly greater than provider confidence before enrollment (P < 0.0001 for all).

Our study revealed that most primary care providers utilizing the Wisconsin Child Psychiatry Consultation Program find it a valuable resource for diagnostic decision-making and improving patient outcomes. This suggests that expanded utilization of the program should be encouraged.

Despite the growing enthusiasm for and a proliferation of digital mental health innovations, their integration into routine clinical care remains limited-often stalled at the pilot, research, or demonstration stage. This editorial argues that the successful adoption, scale-up, and sustainability of digital mental health innovations require intentional infrastructure, not just technology. Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) implementation science framework, we examine how challenges across the seven framework domains (condition, technology, value proposition, adopters, organization, wider context, and their interactions over time) continue to hinder meaningful progress. We describe a focused digital mental health innovation infrastructure as a model for overcoming these barriers. Drawing on experiences from the Digital Innovation Hub at Canada's largest mental health and addictions teaching hospital, we illustrate how investing in the right infrastructure may move digital mental health innovations from "promising" to "impactful." We call for global collaboration to share knowledge and accelerate the real-world integration of digital innovations in routine mental health clinical care.

Personal support workers (PSWs) are often expected to provide ongoing support for complex conditions and have identified an increased need for training in several areas, including dementia and mental health. Web-based interventions may be helpful complements to traditional in-person continuing education and training, but their effectiveness must be explored further.

This study's objective was to evaluate the usability, usefulness, satisfaction with, and effectiveness of the web-based Dementia Foundations Program among unregulated care providers who provide care to persons living with dementia or are in training.

A cohort of 50 PSWs, PSW trainees, and paid care companions from 3 recruitment sites were invited to access the Dementia Foundations Program, a 4-hour self-paced web-based program composed of 4 courses, for up to 6 weeks. Usability, usefulness, and satisfaction were assessed using surveys after each course and following the program. Dementia knowledge and attitudes were measured using the Dementia Knowledge Assessment Scale and the Dementia Attitudes Scale, with differences between baseline and postprogram scores analyzed using repeated measures ANOVA.

Participants reported high levels of satisfaction with the program. Of the 50 participants, 46 (92%) agreed that the web-based training met their expectations, 47 (94%) agreed that the training covered a broad range of topics and was not missing any important content, and 49 (98%) agreed that the web-based training would benefit them. There was a significant postprogram improvement in dementia knowledge as measured by the Dementia Knowledge Assessment Scale, with an average 30% improvement across all cohorts. Dementia Attitudes Scale scores were also significantly improved postprogram across all cohorts.

This pilot study in PSWs, PSW trainees, and unregulated care companions demonstrated high satisfaction levels with the web-based Dementia Foundations Program. There were substantial improvements in knowledge and small improvements in attitudes for participants, and it was perceived as a useful tool that complemented their existing education and training. The Dementia Foundations Program is a user-friendly and effective e-learning program, which can be conveniently scaled and spread to enhance unregulated care provider dementia education.